El Dorado County is a rural county located in northeastern California and is designated as rural by definition through the "Rural Medical Service Study Areas Report" prepared by the Federal Rural Health Policy Council Office which designates all of El Dorado as rural. The total population of El Dorado County is 156,300 spread over 1,805 square miles, or a population density of 86 people per square mile. Innovative features of the ACCEL project include the application of HIT in a rural area to achieve a county- wide patient information system; HIT connections between public and private entities; and solutions for the difficult issue of providing access to and quality health care services for low-income, uninsured, Medicaid eligible and/or minority community patients who currently do not have a "medical home". The ACCEL project will demonstrate and document improved access, improved patient outcomes and improved quality of care to 16,479 currently underserved people. In moving from the planning grant stage to the implementation stage several key decisions have been made by the El Dorado County Safety Net Provider Network (includes the five largest providers of medical services in.the county) which will allow the orderly development and management of HIT practices to reduce medical errors, improve overall patient safety and to extend quality medical care to currently underserved populations. The three year federal funding request is $1,499,800, which is supported by local funding (match) in the amount of $1,518,685 and partner additional contribution in the amount of $2,702,322.